Provider Demographics
NPI:1386131852
Name:PICON, ARMANDO (CRNA)
Entity type:Individual
Prefix:
First Name:ARMANDO
Middle Name:
Last Name:PICON
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HEARTLAND ANESTHESIA CONSULTANTS, P.S.C.
Mailing Address - Street 2:639 NORTH MULBERRY STREET
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-1931
Mailing Address - Country:US
Mailing Address - Phone:270-737-4600
Mailing Address - Fax:270-737-1722
Practice Address - Street 1:HEARTLAND ANESTHESIA CONSULTANTS, P.S.C.
Practice Address - Street 2:639 NORTH MULBERRY STREET
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-1931
Practice Address - Country:US
Practice Address - Phone:270-737-4600
Practice Address - Fax:270-737-1722
Is Sole Proprietor?:No
Enumeration Date:2018-04-19
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11005291367500000X
KY3012218367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered